Your Trauma, Your Body: Protection vs. Connection

Summary:  Join Dr. Peter as he explains how trauma impacts our bodies, through the lens of polyvagal theory. Through quotes, examples, questions for reflection and experiential exercises, Dr. Peter walks you through a current understanding of how large a role our bodies have in our experience of trauma.  
Introduction
 I am Dr. Peter Malinoski, clinical psychologist, bringing to you, my listener the best of psychology and human formation and harmonizing it with our Catholic Faith

 This is the Interior Integration for Catholics podcast -- you are part of it, right here, right now and I am glad to be with you.  This podcast is part of our broader outreach, Souls and Hearts bringing the best of psychology grounded in a Catholic worldview to you and the rest of the world through our website soulsandhearts.com -- we have vibrant communities, we have courses, we have podcasts, we have blogs and shows, all kinds of resources at soulsandhearts.com, check it out.  

Trauma.  Last month, we began a whole series of episodes on trauma -- such an important topic
 Quote from trauma therapist and research Peter Levine:  “Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering.” – Peter Levine

 

We started with an overview of the best of the secular understandings of trauma.  In that first episode in the series, number 88, we got into the definitions of trauma and attachment injuries, and we dived into the experience of trauma -- what trauma is like.  

That sets us up for today's episode, number 89 -- Your Trauma, Your Body:  Protection vs. Connection.  Today, we are getting into the body's response to trauma, really focusing in on what happens in our nervous system.  What happens in the brain, what happens in our spinal cord and our nerves and throughout our bodies
 We will be especially tuning into our own nervous system.   

There's going to be some vocabulary here, I will help you with that. There will some big words, but I am going to walk you through the concepts and make them easier to understand. 

In the past two decades we have learned so much about how trauma impacts the body -- the physiological effects of trauma 
So what is physiological?  Physiology
 
the branch of biology that deals with the normal functions of living organisms and their parts
 organ systems, individual organs, cells, and right down to the level of biomolecules

 The parts within us carry out the chemical, electrical and physical functions within our bodies.  Our bodies are living systems

 

Put simply, physiology is the study of how the human body works

 Today we are looking at how trauma impacts physiology -- how trauma affects the workings of our body, especially in our nervous system.  

Lots of misconceptions out there.  
Old way of understanding stress -- what I learned in graduate school.  Most prominent.  
You were either stressed or not stressed
fight or flight or rest and digest
Stress on or stress off.  No nuance, very simple way of understanding

Today, we are going to do much better than that, go much deeper than that.  

Review: Definition of Trauma 
Integrated Listening Systems website:  Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel a full range of emotions and experiences.
from Duros and Crowley 2014:  …what happens to a person where this is either too much too soon, too much too long, or not enough for too long.  
From Stephen Porges:  Trauma is a chronic disruption of connectedness.  

Most clients come to therapy for one main reason.  One main, overarching reason.  They are dysregulated.  What does that mean?  They are poorly regulated.  
Overwhelmed with emotion or on the other side, Emotional shutdowns, numbing out
Can't control their thoughts, so distracted, intrusive thoughts, ruminations, racing thoughts, obsessions, disorientation, having a sense that their thoughts are no longer under control
Impulses -- rising up
Intrusive memories
They are having trouble keeping it together
High reactivity
Mood swings
Anger management issues
Intense depression
Feeling unreal, depersonalized, not myself, identity issues -- don't know who I am
Feeling fragile, vulnerable, about to fall apart
In one word, they come in to therapy because they can't manage their lives well anymore and they feel losing control and that makes them feel unsafe and scared.  

Polyvagal theory -- Great discoveries in recent years about the vagus nerve.  
The vagus nerve is responsible for the regulation of internal organ functions, such as digestion, heart rate, and respiratory rate, as well as vasomotor activity, and certain reflex actions, such as coughing, sneezing, swallowing, and vomiting
10th of 12 cranial nerves -- On Old Olympus Towering Top, a Finn and German Viewed Some Hops.  Memorizing the cranial nerves
Longest nerve of the body, and the most complex, it branches into 11 different directions.  
Responsible for slowing down all the organs from the next down to the colon.  Parasympathetic response -- slowing or shutting down.  
Responsible
 Heart rate

 Digestion

 Breathing

 Sweating

 Motor functions for the muscles needed for swallowing and speech

 Reflex actions, such as coughing, sneezing swallowing and vomiting

 

 

Polyvagal theory was developed by Stephen xPorges -- Ph.D. in psychology over the last 20 years -- writes in an academic way.  
Relying heavily on the work of Deb Dana Licensed Clinical Social worker and a great writer and speaker - translates him so well
 Polyvagal exercises for Safety and connection -- introduction and first three chapters

 Polyvagal Theory and Trauma – Deb Dana  Nearly 2 hours, on YouTube

 
Deb asks this question:  What would it be like for you if your body could help you feel safe and secure, much more protected  when you start feeling scared?
Fundamental discovery:  Our nervous system is shaped by early experience and reshaped by ongoing experience -- there is connection between our nervous system and our experience.  
Formation of connections and associations
Reshaping -- changing the way our bodies respond to stress -- breaking the old patterns, fashioning new patterns deliberately
Change is gradual
 Fleeting moments of peace --> more consistent sense of well-being, more resilience in the face of challenges, perceived threats, stress.  

Very much at a body level -- not thinking -- about rewiring.  Very basic, bodily level.  

Three organizing principles of polyvagal theory:  Autonomic hierarchy, Neuroception, Co-regulation
 
Autonomic hierarchy
 Autonomic Nervous System -- the part of the nervous system responsible for control of the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes.  Critical theme here -- control of bodily functions not consciously directed.  Regulates what we don't pay attention to.  
Qualities of ANS according to Deb Dana
 Platform for our lived experience

 Internal surveillance system

 Biological resource

 Where our stories begin

 
ANS heavily involved in the ongoing weighing of two fundamental human needs -- two major objectives.  
To survive -- Protection

To bond relationally with others -- Connection

This is the central theme of this discussion of our bodies and our traumas -- Protection and Connection.  How can we have both?  
We have on the one hand a drive to survive -- cause if we don't, you know, we're dead.  On the other hand, we have this yearning to connect, to be in relationship with others 
We need both -- to be protected and to be connected, but trauma puts those two indispensable needs -- protection and connection into tension.  Can't have both.  

If we are experiencing trauma, our ANS automatically moves us away from seeking connection with others to a position of protection. 
In the state of protection -- we are seeking only survival.  Our nervous system is closed to connection with others.  It is closed to change.  There's only one goal.  Survive.  If we don't survive, nothing else is possible.  When we are in a state of protection, it's all about one that one thing: survival.  Nothing else matters.  
However, when we are in a state of connection, we have so many more possibilities
 Health

 Growth

 Restoration

 Change

 

ANS is divided into three parts -- three pronged fork -- the whole fork is the ANS, but the three prongs are the Dorsal vagal system, the Sympathetic System and the Ventral Vagal System.   Vagal nerve is part of the parasympathetic system, so in broad terms, it slows us down. 
Dorsal vagal system (back) 
Earliest, most basic system.  
Strategies of immobilization.  Playing dead.
Very disconnected, very shut down.  
Freeze response
Deb Dana uses the image of a turtle hiding in its shell.
Protection through disappearing  

Sympathetic system (not vagal)
 Next to develop in evolution

 Strategies of hyper-mobilization.

 Fight or flight

 Deb Dana:  Darting movements of a fish to escape a predator

 Protection through action.

 
Ventral vagal system (front) 
Unique to mammals -- don't see this in reptiles.  
Ability to experience a felt sense of safety
Through connection and social engagement
Very relational

Dissolution -- predictable way that things break down in us when we are overwhelmed.  
Neuroimaging studies have repeatedly shown that in overwhelming situations in which we are flooded, our prefrontal cortex shuts down
 The prefrontal cortex is the part of the brain needed for rational thought -- for planning, considering different options.  

On imaging studies that look at electrical activity in the brain, when we are flooded, overwhelmed, our prefrontal cortex, which we really need for higher-order thought, shuts down.  It does dark.  It goes offline.  Not accessible.

 And then other, more primitive parts of the brain take over.  These more primitive parts of the brain can't really think rationally.  But these primitive parts of our brain, when they are activated in overwhelming situations can and do react and respond.  And this feels to us very automatic, not considered.  

Experience in the ventral vagal state.  -- Example here
 Ventral vagal system is all about connection and social engagement

 
Warmth, positivity, connectedness.  
Wellbeing, able to accurately interpret cues for safety
Social, engaged
Connected internally 
Connected to the world
Flexibility, resilience
Sense of hope
Capacities
 Tune into the present moment

 Filter out distractions

 
Can co-regulate
Can Self-regulate
Able to reach out to others and provide support and resources
Engage all of our brain, including higher-order thinking
Explore options
Compassion for self and others

Lots of possibilities for connection.  
The story we have active is a good story, one with goodness and peace and joy.  

Questions for reflection from Deb Dana
 What is it like for you when you are in the ventral vagal state -- warm toward others?

 What are some of the stressful events in life or difficult relationships that might take you out of that connected, socially engaged ventral vagal state and move you toward sympathetic arousal, the fight or flight mode?

 

 

 

What happens when the ventral vagal system shuts down
 
Compromised by
 Feeling deeply alone -- loss of a loved one -- romantic breakup, divorce, death, but also ways that are not so obvious -- adult children not reaching out

 Too many responsibilities in the day, to many things to do, the checklist has so much that is not crossed off, we start getting worked up, you can feel the tension inside rising to a fight or flight level.  

Being distressed in relationship -- relational conflicts, arguments, coldness, distance.  

Bring in the example

When the sympathetic system is activated, we are all about survival now
 Familiar to us as the "Fight or Flight" mode.  

Very high levels of energy in this state, adrenaline rush

 Body is mobilized for action.  The Klaxons are going off, Battle stations. Not a lot of relationality when you are in fight or flight

 
Capacity for complex, flexible reasoning is very much reduced
 Can you imagine playing a good game of chess while you are in a fight or flight mode?

 Running away from a tiger -- not time to digest your Power Bar.  

Muscle tension in back -- muscles getting locked up.  Tight, rigid back muscles.  Not responsive to stretching doesn't work, massage, chiropractic, rollers, physical therapy -- downregulating can be so helpful.  

No sense of safety.

 Potential for panic

 Potential for rage

 Confusion

 Overwhelmed

 Angry

 Confrontational

 Ready to run

 
Properties
 You have a sense of unease and impending danger

 
Your body is mobilized for fight or flight -- inner Klaxons are going off, the alarms
 High levels of energy, endocrine system is now active, adrenaline rush, 

Active aggression -- Damn the torpedos, full speed head.  -- lashing out before he even knows what he is doing…

 Efforts to escape

 Hypervigilance -- high alert, pupils dilating, letting more light.  Looking for and listening for danger

Missing and misreading signs of safety

 Sense of separation, isolation -- cut off from others, no sense of relational connection anymore

 Disconnection from self, others, world, disconnected spiritually.  Therefore We can't provide safety to others in this sympathetic activation state.  

We can't sustain this -- adrenaline, cortisone up all the time.  Can't take it.  Heart couldn't stand it.  
Story: The world is unsafe and people are dangerous, unfriendly, scary, falling apart
 I am crazy, I am toxic,

 Unlike simple stress, trauma changes your view of your life and yourself. It shatters your most basic assumptions about yourself and your world — “Life is good,” “I’m safe,” “People are kind,” “I can trust others,” “The future is likely to be good” — and replaces them with feelings like “The world is dangerous,” “I can’t win,” “I can’t trust other people,” or “There’s no hope.”― Mark Goulston MD

Questions for reflection from Deb Dana
 What does mobilization feel like for you -- when you get revved up?

 Where does mobilization take you?  Into fight or flight.  

When the mobilization doesn't bring a resolution to the distress -- then the ANS takes the final step, and shoots the last arrow it has in its quiver.  This is the freeze response.  
Situation is so desperate, there is nothing I can do. 
Collapse into "dorsal vagal lifelessness"  -- Dorsal vagal system takes over, and shut us down.  
Everything goes offline, almost all the brain.
Shifting into conservation mode.  
Response to what seems inescapable
Properties
 Conservation mode

 Numbing out

 
Disconnection
Dissociation, Spacing out, feeling disconnect from the present, untethered, floating, derealization
Fogginess, fuzziness
Collapse -- rape example
Alone, lost, unreachable
Invisible
Loss of identity, depersonalization
Safety and hope are lost\
Loss of consciousness altogether
Lethargy -- can feel really sloggy, like you are heavily sedated
 Experience of being stuck, frozen.  

Despondency
Shame -- episode 37-49
Dark, silent, cold
Could be overly calm
I am a rock, I am an island -- Paul Simon -- doesn't work.  All about protection there, not connection.  

Loss of abilities
 Can't listen.  

Can't share very well, difficulty with words

 Very little agency

 Can't focus

 
Story:  A story of despair.  
Message of I am unlovable, invisible, lost, alone
The world is cold, empty, unhabitable.  Vincent -- Don McClean

Questions for reflection from Deb Dana
 Is the experience of dorsal vagal shutdown familiar to you?

 How does the sense of disconnection happen for you?

 
Review of the autonomic hierarchy -- first of three organizing principles
 Connection vs. Protection

 Drive to survive vs. drive to bond with others.  Where is the safety?

ANS is divided into three parts -- three pronged fork -- the whole fork is the ANS, but the three prongs are 
Ventral Vagal System
the Sympathetic System
the Dorsal vagal system

Second of the three organizing principles in Polyvagal Theory:  Neuroception
 Definition:  Detection without awareness -- we sense something but it is below the limit of what we can consciously experience.  

Neuroception is the way our autonomic nervous system listens below the level of awareness -- deeply subcortical experience -- not in our rational, prefrontal cortex brain.  Reactions happen long before conscious thought.  Really important to understand that neuroception is not a conscious process.  
inside our body -- to our organs
Outside of us -- in our environment -- checking
And between, sensing connections to others, especially others' nervous systems -- this is all about relationships.  
At work all the time. 

Neuroception picks up on cues, all the time
 Cues of safety lead us to ventral vagal activation and interpersonal connection, social engagement -- so a neuroception of safety calms, connects, and dampens the need for protection.  

Cues of danger -- lead us into the sympathetic arousal, fight or flight
 Facial expressions

 Tone of voice

 Not just words.  Vocal bursts

 
Interpreting head movements
 Nodding head, welcoming.

 Straight unmoving head is a cue for danger

 Slight tilt is inviting, a welcome sign

 

Subtle cues

 
Cues of life-threat lead us into dorsal vagal shutdown, moving toward that collapse, that state of total numbing and disconnection.  
Our neuroception is constantly scanning inside and outside -- what is the social temperature of the people in the room
 Friendly and inviting

 Hot and bothered

 Cold and calculating

 
Neuroception of safety is incompatible with a neuroception of danger or life-threat.    
When we are in distress, when we are dysregulated
 We miss cues for safety

 We misread neutral cues as dangerous.    

Autonomic patterns and autonomic profiles can be reshaped -- we start with neuroception -- unlike a lot of therapist, which start with much higher-order thinking -- like cognitive-behavioral therapy.  
Order -- Neuroception - Perception - State - Emotions - Behavior - Story. 
Neuroception
Perception
State
Emotions
Behavior
Story -- our Narrative

What is our story?  How much of our life is about protection and how much of our life is about connection?
 
Dovetail here with Brown and Elliott
 Felt sense of safety and protection -- not enough that there be actual safety and protection -- it has to be felt, it has to be taken in.   

We want to be able to edit the story. 
Trauma stories are carried in states of dysregulation.

Review of Neuroception:
 Definition:  Detection without awareness.  Sensing below conscious awareness.  

In my body, outside of me in my environment, between me and my environment.  

Cues of safety -- lead us to ventral vagal activation, interpersonal connection, social engagement

 Cues of danger lead us to sympathetic arousal, fight or flight

 Cues of life threat lead us to dorsal vagal activation, freeze response, shutting down.  

Questions for personal reflection from Deb Dana'
 
Your neuroceptive cues
 What is a cue of safety inside your body --  calm and expansive -- feels like I have a big open heart.  

What is a cue for danger from inside your body

 What is a cue of safety for you from your environment

 What is a cue for danger in your environment

 What is a cue of safety between you and another person

 What is a cue for danger between you and another person?

 Review these for me. 
What is a cue of safety inside your body --  calm and expansive -- feels like I have a big open heart, like my heart is reaching out to others.  
What is a cue for danger from inside your body -- jaw clench.  Also, icewater in veins.  
What is a cue of safety for you from your environment  -- I like quiet, warm, rooms with sunlight and comfortable furniture and drinking tea.  
What is a cue for danger in your environment -- dogs.  Very suspicious of dogs -- days as a runner.  Semi trucks not holding the lane on the freeway. And any teenage child of mine learning to drive.  
What is a cue of safety between you and another person -- genuine smile -- smiling with eyes, Duchenne smile.  Soft voices, gentle laughter.  
What is a cue for danger between you and another person?  Yelling in anger, sensitive to sarcasm, especially if I perceived contempt.  

Experiential exercise
 Going inside right now.  

Protection

 Connection

 

Co-regulation
 Deb Dana:  When we feel alone in the world, we suffer.  When that feeling is chronic, medical and mental health risks multiply.  

Deb Dana: Our autonomic nervous system longs for connection with another system and sends signal out  into the world searching for signals in return. 
Stephen Porges (2016).  Survival is dependent on opportunities to successfully co-regulate.   
Co-regulation is essential for us for our well-being. In short, we need each other.  People need people.  
Connection is a wired-in biological necessity
Fisher (2014) Without the experience of an organizing other, the nervous system is stunned.
Trauma survivors suffer from a lot of dysregulation -- unpredictable shifts inside, rapid mood swings, thoughts that seem out of control, imagery that can be terrifying and then rapidly cease, body sensations that are so intense that they overwhelm, impulses that can seem bizarre -- we covered all those symptoms of trauma in the last episode, number 88: Trauma: Defining and Understanding the Experience -- you can check that out.  

Central idea:  The ability to regulate oneself is built on ongoing experiences of co-regulation
Through co-regulation, we connect with others and experience a shared sense of safety.  Safety together. Safety in relationship.  
We need a reliable person in our lives to help us engage in what Deb Dana calls the "rhythm of  reciprocity" and build shared experiences of safety in connection.  
A safe person in a safe place
 Sue Johnson' “Emotional connection is crucial to healing. In fact, trauma experts overwhelmingly agree that the best predictor of the impact of any trauma is not the severity of the event, but whether we can seek and take comfort from others.”

 Lilly Hope Lucario:  “I have a gaping, painful hole in my soul… where good, loving parents and a normal, safe childhood, should have been.” – Lilly Hope Lucario

 
Can listen.  
This goes back to long before birth -- Mother and baby are sharing at an autonomic level -- nervous systems are actually connected in various ways.  
Right after birth -- two births, Grace 1998 and James 2010.  Contrast in birthing practices
 Kangaroo care, skin-to-skin, 

Positive outcomes for babies  Jeffries (2012)
 heart, temperature, breathing stabilization

 More organized sleep

 Babies depend on their caregivers, their mommies, to bring their regulated nervous systems to the connection.

 

Uninterrupted attunement is not necessary -- really only need about a third of the time (Ostlund and colleagues 2017)
Joy, playfulness, love
We are in the present.  
Sense of well being.  
This state of well-being is where we can offer a sense of safety to others.  Recollection.  
What happens after a mismatch?  This is the key thing.    
Mismatch
 
Inability to calm defense systems in safe environments
 Alarm

 Hypervigilance

 

Inability to activate defenses in risk environments
 Dulled

 Unaware

 High risk-taking

 

Without it
 Health challenges

 Distress in relationships (no safety)

 Daily experience of suffering.

 
This is really were Daniel Siegel's interpersonal neurobiology shines. 
Interpersonal neurobiology (IPNB) or relational neuroscience is an interdisciplinary approach developed to describe and explain human development and functioning. It emerged in the 1990s pioneered by Daniel J. Siegel who sought to bring together a wide range of scientific disciplines in demonstrating how the mind, brain, and relationships integrate to alter one another.
 Psychology

 Cognitive Science

 Biology

 Psychiatry

 Sociology

 Systems theory -- chaos theory and complexity theory.  

Anthropology

 Computer Science

 Linguistics

 Mathematics

 Physics

 
 In IPNB, the mind is viewed as a process that regulates the flow of both energy and information through its neurocircuitry, which is then shared and regulated between people through engagement, connection, and communication.  Drawing on systems theory, Siegel proposed that these integrated processes within interpersonal relationships can shape the genetically programmed maturation of the nervous system.[2] Seigel thus believes that the mind has an irreducible quality which informs his approach.
Interpersonal neurobiology also proposes that there is a substantial impact of interpersonal experiences on brain development during early developmental years.[3][4] Siegel assumes that disruptions to the continuity, presence, and availability of the caregiver result in attachment disorders that manifest as physical changes[5][6] in the neural structures that shape the perception of reality.[7] The claim is that this can influence one's emotional intelligence, complexity of behaviours, and flexibility of responses later in life.[5] IPNB is thereby argued to be a 'cause and effect' systematic interaction between genetic composition and social experiences influencing neurobiological and psychological functioning.[8][9] 

  Being with each other. 

Exercise -- Informed by Deb Dana
 Cautions.

 
First Part
 Noticing where you are right now on the autonomic map

 Name the state

 Turn toward your experience

 Bring curiosity and compassion to the experience

 Listen to the story.  

Baby in a state of sympathetic arousal
 Warning

 
Noticing what happens inside your body
 Moving from one state to another 
Ventral Vasal -- warm, connected state
Sympathetic arousal -- fight or flight
Dorsal Ventral -- shutting down, freeze response
Cues -- meaning, messages
How might it related to your history?

Toddler laughing
 
Noticing what happens inside your body
 Moving from one state to another 
Ventral Vasal -- warm, connected state
Sympathetic arousal -- fight or flight
Dorsal Ventral -- shutting down, freeze response
Cues -- meaning, messages
How might it related to your history?

Not judging
 Judge not that you not be judged.  Matthew 7:1.  

1 Samuel 16:7   for the Lord sees not as man sees; man looks on the outward appearance, but the Lord looks on the heart.” 

So much of our internal experience is outside of the influence of our immediate will

 Great mistake we make -- illusion of willpower

 
Future Directions -- where we will be zeroing in
 Thank you for being here with me

 This episode was bringing to you the impact of trauma on the body through the lens of polyvagal theory

 Next episode  Common treatment modalities -- EMDR and other ways of treating trauma -- that's a really important one.  How do we heal from trauma

 Then we will get into an Internal Family Systems approach to trauma

 
Then we will bring all this groundwork on trauma together to address the spiritual dimensions of trauma
 Really neglected area

 So important.  How trauma impacts the spiritual life.  

You are a listener to this podcast, and in that sense, you are with me.  I am also with you!  Remember, can call me on my cell any Tuesday or Thursday from 4:30 PM to 5:30 PM for our regular conversation hours.  I've set that time aside for you.  317.567.9594.  (repeat) or email me at [email protected]. 

Sign up for the RCC waiting list.  
Check out soulsandhearts.com

Resources
 
Polyvagal Theory Explained Simply  Sukie Baxter\

 
Polyvagal Theory and Trauma – Deb Dana  Nearly 2 hours, on YouTube